Risk Stratification in Patients With Brugada Syndrome Without Previous Cardiac Arrest : Prognostic Value of Combined Risk Factors

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  • Okamura Hideo
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
  • Kamakura Tsukasa
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Morita Hiroshi
    Department of Cardiovascular Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama University
  • Tokioka Koji
    Department of Cardiovascular Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama University
  • Nakajima Ikutaro
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Wada Mitsuru
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Ishibashi Kohei
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Miyamoto Koji
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
  • Noda Takashi
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Aiba Takeshi
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Nishii Nobuhiro
    Department of Cardiovascular Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama University
  • Nagase Satoshi
    Department of Cardiovascular Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama University
  • Shimizu Wataru
    Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University Department of Cardiovascular Medicine, Nippon Medical School
  • Yasuda Satoshi
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
  • Ogawa Hisao
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
  • Kamakura Shiro
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Ito Hiroshi
    Department of Cardiovascular Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama University
  • Ohe Tohru
    Department of Cardiovascular Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama University
  • Kusano Kengo F.
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University Department of Cardiovascular Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama University

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タイトル別名
  • Risk Stratification in Patients With Brugada Syndrome Without Previous Cardiac Arrest
  • – Prognostic Value of Combined Risk Factors –

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Background:Risk stratification in patients with Brugada syndrome for primary prevention of sudden cardiac death is still an unsettled issue. A recent consensus statement suggested the indication of implantable cardioverter defibrillator (ICD) depending on the clinical risk factors present (spontaneous type 1 Brugada electrocardiogram (ECG) [Sp1], history of syncope [syncope], and ventricular fibrillation during programmed electrical stimulation [PES+]). The indication of ICD for the majority of patients, however, remains unclear.Methods and Results:A total of 218 consecutive patients (211 male; aged 46±13 years) with a type 1 Brugada ECG without a history of cardiac arrest who underwent evaluation for ICD including electrophysiological testing were examined retrospectively. During a mean follow-up period of 78 months, 26 patients (12%) developed arrhythmic events. On Kaplan-Meier analysis patients with each of Sp1, syncope, or PES+ suffered arrhythmic events more frequently (P=0.018, P<0.001, and P=0.003, respectively). On multivariate analysis Sp1 and syncope were independent predictors of arrhythmic events. When dividing patients according to the number of these 3 risk factors present, patients with 2 or 3 risk factors experienced arrhythmic events more frequently than those with 0 or 1 risk factor (23/93 vs. 3/125; P<0.001).Conclusions:Syncope, Sp1, and PES+ are important risk factors and the combination of these risks well stratify the risk of later arrhythmic events. (Circ J 2015; 79: 310–317)

収録刊行物

  • Circulation Journal

    Circulation Journal 79 (2), 310-317, 2015

    一般社団法人 日本循環器学会

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